Primary treatment of nasolacrimal duct obstruction with balloon catheter dilation in children younger than 4 years of age.
OBJECTIVE
To report the outcome of nasolacrimal duct balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction (NLDO) in children younger than 4 years of age.


METHODS
One hundred two children (151 eyes) ages 12 to <48 months (mean, 23 months) at the time of surgery, who previously had not undergone a nasolacrimal surgical procedure and who presented with at least one of the following clinical signs of NLDO--epiphora, increased tear lake, and/or mucous discharge--were enrolled in a prospective, nonrandomized observational multicenter study (20 sites). All children received balloon catheter dilation of the nasolacrimal system of the affected eye(s).


RESULTS
Treatment success was defined as no epiphora, increased tear lake, and/or mucous discharge present at the outcome visit at 1 month after surgery. The proportion of eyes treated successfully was 82% (95% CI: 74%-88%). The dye disappearance test at outcome was normal in 105 (73%), indeterminate in 15 (10%), and abnormal in 23 (16%) of the 143 eyes tested.


CONCLUSIONS
In children 12 to <48 months of age, balloon catheter dilation as a primary treatment of NLDO was successful in approximately 80% of cases. Because we did not perform a randomized trial with a comparison group, we were unable to determine how this procedure's success rate compares with that of simple probing or nasolacrimal intubation in this age group.
Repka
Michael X
MX
Melia
B Michele
BM
Beck
Roy W
RW
Chandler
Danielle L
DL
Fishman
Deborah R
DR
Goldblum
Todd A
TA
Holmes
Jonathan M
JM
Perla
Bernard D
BD
Quinn
Graham E
GE
Silbert
David I
DI
Wallace
David K
DK
D002404:Catheterization; D002675:Child, Preschool; D005260:Female; D019793:Fluorescein / Q000493:pharmacokinetics; D005456:Fluorescent Dyes / Q000493:pharmacokinetics; D006801:Humans; D007223:Infant; D007766:Lacrimal Apparatus Diseases / Q000209:etiology; D007767:Lacrimal Duct Obstruction / Q000150:complications / Q000628:therapy*; D008297:Male; D009301:Nasolacrimal Duct; D011446:Prospective Studies; D011788:Quality of Life; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome
D005456:Fluorescent Dyes; D019793:Fluorescein